On 5 June 2011, the world marked an unhappy anniversary: 30 years since the first diagnosed case of what would later become known as AIDS. Three decades in the history of humanity – so brief a span of time yet so significant, a time of infection spreading like wildfire, of those afflicted treated like lepers, abandoned to suffer agonizing deaths. The advent of antiretroviral treatment (ART), not to cure but to contain HIV/AIDS, has made an enormous difference, keeping millions of people alive and well. But for many years rollout of treatment in developing countries proved to be painfully, at times fatally, slow.
No continent has suffered more than sub-Saharan Africa, where AIDS has flourished in an unholy alliance with other evils: structural injustice, poverty, hunger, war, gender inequality and corruption, to name a few. In mid-2010, 68% of a global total of 34 million people living with HIV were in sub-Saharan Africa – 22.9 million people.
Increased access to treatment
Thanks to growing treatment and prevention efforts, less people are dying and there are fewer new infections in many countries. These international efforts, embodied in the UN “universal access” drive, mean that more than 5 million people have access to affordable fixed-dose combination drugs today. In 2010 alone, sub-Saharan Africa had the greatest increase in the number of people receiving ART, from 3,911,000 in December 2009 to about 5,064,000 a year later. Recent scientific evidence has underlined the ability of ART to not only treat people with HIV but also to prevent the spread of the virus by suppressing viral replication.
The battle is far from over
But the battle is still far from won even if complacency appears to be creeping in. The 1.9 million people who became newly infected with HIV in 2010 in sub-Saharan Africa represented 70% of all the people who acquired HIV infection globally. And despite gains in rolling out treatment, only 49% of those eligible for treatment in sub-Saharan Africa were able to access it in 2010. What’s more, treatment gains are now threatened by donor fatigue and by many other challenges: weak and inadequate health systems, drug shortfalls, corruption, stigma and poverty. The last translates into patients’ lack of means to pay for nutritious food, for other medical costs like testing or treatment for opportunistic infections, or for transport to reach the clinic.
Not just a medical problem
While medication is utterly crucial for people with HIV, it is far from their only need. AJAN has consistently underlined the need for a holistic approach to support those infected and affected, one that takes into account all aspects of the human person, including his/her relationships - personal, with family, community, culture and society. This means offering pastoral ministry, counselling, income-generating and micro-credit opportunities, helping children to go to school, and many other services.
This is perhaps the most significant truth about AIDS in Africa: it is not simply a medical problem. It is a matter of justice. The African Catholic Bishops, meeting in Rome in 2009, were clear about this: “It [HIV/AIDS] is not to be looked at as either a medical-pharmaceutical problem or solely as an issue of a change in human behaviour. It is truly an issue of integral development and justice.”
A matter of justice
Fr Michael Kelly SJ, a Jesuit in Zambia who is a renowned expert speaker and author on AIDS, writes: “The pandemic is in itself oppressive and dehumanising. Moreover, its spread is rooted in, and promoted by, human structures and systems that are themselves oppressive:
- Stigma and discrimination
- Imbalances in gender understandings, relationships and power structures
- Economic imbalances
- Certain traditional/cultural perspectives and practices
- North-South relationships
- Globalisation as practised
- Extensive movement of people in search of security, work or improved life prospects.”
Where prevalence rates are high, the pandemic constrains the development of individuals, families, communities and countries. In a word, as Fr Kelly puts it, “AIDS exacerbates injustice. Injustice aggravates AIDS. One cannot be understood or tackled without the other.”
The Catholic Church contribution to fighting AIDS in Africa
The Vatican estimates that Catholic Church-related organizations provide approximately 25% of all HIV treatment, care, and support throughout the world. The proportion is higher in Africa, nearly 100% in the remotest areas.
In 2010, the Vatican reported that the Catholic Church supported more than 5,000 hospitals, 18,000 dispensaries, and 9,000 orphanages, many involved in AIDS-related activities.
Apart from this considerable contribution, the Catholic Church is ideally placed to offer wider comprehensive care to people with HIV, their families and orphans, and to seek to prevent the spread of the pandemic. Put simply, the Church is already there, its presence in the community is well established; it does not need to go to set up projects to deal with HIV/AIDS and indeed any of the other challenges that Africa faces. The home-based care offered in parishes to people with HIV and orphans is only one – successful and striking – example of the way in which the Church reaches out at community level.
The Church is also active in prevention of HIV, delivering its message through its vast network of parishes, schools and other works. Its message focuses on the values of compassion, respect for life, abstinence and fidelity, and on accurate information about HIV and AIDS. Voluntary counselling and testing is encouraged. Many Church organisations focus on the prevention of mother-to-child transmission (PMTCT).